Wang C C, Wu M S, Wang H H, Wang H P, Lee W C, Shun C T, Lin J T
Department of Internal Medicine, College of Medicine and Institute of Epidemiology, National Taiwan University, Taipei, ROC.
Hepatogastroenterology. 1998 Nov-Dec;45(24):2234-7.
BACKGROUND/AIMS: Both intestinal metaplasia (IM) and Helicobacter pylori (H. pylori) infection have been linked to gastric carcinogenesis in an age-dependent manner. However, their relationship remains ill defined, especially with respect to age.
Three hundred and two asymptomatic subjects (167 males and 135 females; mean age 44.3+/-11.1 years) underwent complete endoscopic examination and biopsy at the antrum and the corpus. H. pylori infection was diagnosed according to histopathology and serology, while IM was determined by histopathology.
Eighty-four patients (27.8%) had IM, while 185 patients (61.3%) were seropositive to H. pylori. The frequency of IM was higher in patients with gastric ulcer (9/14, 64.3%) than in those with minimal change (68/229, 29.7%) or duodenal ulcer (7/59, 11.9%), both p<0.01. Patients with IM had a higher mean age (49.5+/-14.1 vs. 42.3+/-9.0, p<0.01) and a higher H. pylori prevalence than those without IM (61/84, 72.6% vs. 124/218, 56.9%, p<0.01). The concordance rate of H. pylori infection between histopathologic and serologic diagnosis was lower in patients with IM (67/84, 79.8%) than those without (196/218, 89.9%, p<0.05). Using logistic regression analyses, the development of IM was noted to be independently related to both H. pylori infection (odds ratio=1.97, 95% confidence interval: 1.1(3.53)) and age (odds ratio = 1.93, 95% confidence interval: 1.51(2.47)).
These data suggest that age and H. pylori infection are independent risk factors for the development of IM. Furthermore, H. pylori infection may have been underestimated in patients with IM because of the use of a single method of detection.
背景/目的：肠化生（IM）和幽门螺杆菌（H. pylori）感染均与胃癌发生存在年龄依赖性关联。然而，它们之间的关系仍不明确，尤其是在年龄方面。
302名无症状受试者（167名男性和135名女性；平均年龄44.3±11.1岁）接受了完整的内镜检查，并在胃窦和胃体取活检。根据组织病理学和血清学诊断H. pylori感染，而IM通过组织病理学确定。
84例患者（27.8%）有IM，185例患者（61.3%）H. pylori血清学阳性。胃溃疡患者中IM的发生率（9/14，64.3%）高于轻度改变患者（68/229，29.7%）或十二指肠溃疡患者（7/59，11.9%），两者p<0.01。有IM的患者平均年龄更高（49.5±14.1对42.3±9.0，p<0.01），且H. pylori感染率高于无IM的患者（61/84，72.6%对124/218，56.9%，p<0.01）。IM患者中H. pylori感染的组织病理学诊断与血清学诊断的符合率（67/84，79.8%）低于无IM的患者（196/218，89.9%，p<0.05）。通过逻辑回归分析，发现IM的发生与H. pylori感染（比值比=1.97，95%置信区间：1.1（3.53））和年龄（比值比=1.93，95%置信区间：1.51（2.47））均独立相关。
这些数据表明年龄和H. pylori感染是IM发生的独立危险因素。此外，由于采用单一检测方法，IM患者中H. pylori感染可能被低估。
